MEDICAL MIRACLE DURING COVID TIMES

MEDICAL MIRACLE DURING COVID TIMES – ASIA’S FIRST BILATERAL LUNG TRANSPLANT ON A COVID POSITIVE PATIENT

Despite the challenges posed during these COVID-19 times, MGM Healthcare, a multi-specialty quaternary care hospital in the heart of the city, became the third hospital in the world to announce the successful completion of a critical bilateral lung transplant on a COVID-19 positive patient. This is Asia’s first known lung transplant on a COVID-19 positive patient and the second lung transplant in the hospital since the lockdown began.

The transplant was led by Dr. K. R. Balakrishnan, Chairman & Director of Cardiac Sciences and Director of the Heart and Lung Transplant Program at MGM Healthcare, and his team of transplant specialists including Dr. Suresh Rao, Dr. Srinath and Dr Apar Jindal.

The transplant was performed on a 48 year old gentleman from Delhi, who was suffering from severe lung infection with COVID-19.  His lungs were severely damaged due to COVID-19 related fibrosis. He developed COVID infection on 8^th June 2020.  Only a small portion of the lungs was still functioning. As he became breathless and oxygen saturation came down he was put on ventilatory support on 20^th June 2020.  His condition continued to be worsening in spite of ventilator support, he was airlifted to MGM Healthcare from Ghaziabad on 20^th July 2020.  His lung condition continued to be worsening in spite of maximum ventilatory supportive care, and he was put on ECMO support on 25^th July 2020 for more than one month. Such patients are difficult to manage even in well-equipped ICUs.

Commenting on the procedure, Dr. K. R. Balakrishnan said, “We were initially in a dilemma when his case was referred to us. But as doctors, we are taught to prioritise the patient’s overall health over anything else. Keeping this in mind, we decided to proceed with the surgery. Here I would like to commend and thank my team of doctors and the other support staff for taking up the challenge and boldly standing by the decision to go ahead with the transplant, without thinking about the risk to their own health and safety. We are happy for the patient as the transplanted lungs are working well.”

According to Dr. Suresh Rao, as the patient’s both transplanted lungs were working well, we removed the ECMO support.  Now his clinical condition is stable.  At the same time, we accepted the heart from the same donor to another patient who was waiting for a heart transplant, thereby giving a new lease of life to two people”.

Commenting on the patient’s condition, Dr. Apar Jindal said, “On 21^st August 2020, we repeated his chest CT, but patient’s lungs were totally destroyed and had severe fibrosis.  Hence we went ahead with the bilateral lung transplant”

“While the lockdown and the phased unlocks are a much-needed moves to limit the community's chance of exposure to the Coronavirus, MGM believes that healthcaring must go on. The good news from a healthcare perspective is that despite the travel restrictions imposed by the Government, both at the Centre and State levels, medical contingency travel was never a problem if a patient and close family members followed the procedures laid down. It’s indeed a proud moment for MGM Healthcare…the long distance travel that the patient and his family decided to undertake despite the limitations is testimony to our expertise when it comes to transplants. I would also like to take this opportunity to thank everyone who played a role in ensuring that he reached us at the earliest for the next treatment steps to be expedited,” adds Dr. Prashanth Rajagopalan, Director, MGM Healthcare.

The transplant was performed on August 27, 2020. Post the transplant, the patient is doing fine in the Transplant ICU at MGM Healthcare.

ORGAN FLOWN FROM PUNE TO CHENNAI AMIDST THE

ORGAN FLOWN FROM PUNE TO CHENNAI AMIDST THE PANDEMIC FOR A SUCCESSFUL HEART TRANSPLANT AT MGM HEALTHCARE

§  Donor heart flown down to Chennai from Pune by air ambulance

§  ‘Green Corridors’ created in both the cities

Despite the enormous challenges posed during these COVID-19 times, MGM Healthcare, a multi-specialty quaternary care hospital in the heart of the city, today announced the successful completion of a second critical heart transplant in the hospital since the lockdown began.  The heart transplantation was led by Dr. K. R. Balakrishnan, Chairman & Director of Cardiac Sciences and Director of the Heart and Lung Transplant Program at MGM Healthcare, along with his team of transplant specialists including Dr. Suresh Rao K. G. and Dr. Srinath V. The organ transplantation regulatory authorities and surgeons from Pune extended their full support in making this heart transplant a success especially considering that it occurred during the COVID times.

The transplant was performed on a 37-year-old lady from Chennai. She had been suffering from ischemic cardiomyopathy. The patient was suffering from end stage heart failure and transplant was the only form of survival.

MGM Healthcare received an alert on August 15, 2020 about a 39-year-old brain dead female patient at a private hospital in Pune. The cause of her brain death was reported to be Brain Hemorrhage.

MGM Healthcare immediately confirmed the requirement as the recipient was already registered in the waiting list handled by National Organ and Tissue Transplant Organisation (NOTTO). Post registration, she was waiting for a suitable donor. Once the deceased patient in Pune was identified based on medical compatibility, the recipient was informed about the possibility of the transplant taking place after taking consent from the donor’s family.

“The biggest challenge faced was the non-availability of any commercial flight between Pune and Chennai around the organ retrieval time. As the transplant was funded by Tamil Nadu Govt scheme and no commercial flight was not available arranging a chartered flight was challenging. We approached Aishwarya trust for the same and Mrs Chitra was kind enough to sponsor the same and an air ambulance was arranged” said Dr K R Balakrishnan.

The respective Traffic Police Departments in both Pune and Chennai opened ‘Green Corridors’ for road travel from the hospital in Pune to Pune Airport; and from Chennai Airport to MGM Healthcare. The donor organ landed in Chennai at 6:30 P.M. on August 16, 2020. The ambulance carrying the organ reached MGM Healthcare from Chennai Airport in 11 minutes flat, which under normal traffic conditions would take anywhere between an hour to an hour and a half. The transplant procedure started immediately after the heart reached MGM Healthcare. Post-transplant, the patient has been moved to ICU for observation.

Commenting on the transplant Dr Suresh Rao said “The Heart transplant was successfully performed by 9:00 pm and the patient is off ventilator and doing well”.

Speaking on the occasion, Harish Manian, CEO, MGM Healthcare said, “This is indeed a proud moment for MGM Healthcare…an instance where despite the challenges posed on account of the ongoing COVID-19 pandemic, various state machineries including the Traffic Police Department, Airport Authorities, Air Ambulance seamlessly collaborated to reach the organ to our hospital in the shortest possible time, becoming an integral part of our ‘Healthcaring Movement’. I would like to take this opportunity to thank each and every one who supported us in giving a fresh lease of life to the young lady.” 

TNMSC & MGM | 25-50% of the people infected with COVID-19 reported

“TNMSC & MGM” | 25-50% of the people infected with COVID-19 reported to develop symptoms

25-50% of the people infected with COVID-19 reported to develop symptoms of Acute Kidney Injury (AKI). A few patients even developed Acute Kidney Injury (AKI), a condition known to impact survival of patients. Also, a recent report of the International Society of Nephrology (ISN) reveals that of the people infected with COVID-19, 25-50% of them were seen with Kidney abnormalities, which manifested as a substantial leak of protein and blood in urine, resulting in the development of AKI in close to 15% patients, hinting that COVID-19 also attacks the kidney

Dr. Suresh Rao, Intensivist, MGM, Chennai says “Effect on the kidney is secondary to hypoxia or cytokines released by the covid19. It is generally perceived that COVID-19 types of viruses are borne from respiratory systems — Lungs, but a growing body of evidence shows that COVID-19 also attacks the kidneys either directly or mediated by excessive immune response seen in severe COVID-19 patients and not just the lungs. As per earlier reports of SARS and MERS-CoV infections, Acute Kidney Injury (AKI) had developed in 5 to 15 per cent cases, but about 60 to 90 per cent of those cases reported mortality. While the preliminary reports of COVID-19 patients suggested a lower incidence (3 to 9 per cent) of AKI, the later reports indicated a higher frequency of kidney abnormalities. A study of 59 patients with COVID-19 found that about two-thirds of patients developed a massive leak of protein in urine during their stay in hospital”,

Dr. NGK Gopal Nephrologist, TNMSC, Chennai says “Previous studies show that CRRT had been successfully applied in the treatment of SARS and MERS illnesses related to previously known coronaviruses, which also manifested as respiratory illnesses.  At relatively higher doses, it can help clear the immune toxins, thus suggesting CRRT may play a role in patients with COVID-19 with AKI or high immune toxin load”